Table 1. Direct medical costs per procedure/year by stage of diagnosis of BC. Current scenario in Mexico 2009.
| Resource or service | Use of service* | Unit Cost | ||
|---|---|---|---|---|
| IMSS | SPSS | |||
| Diagnosis | ||||
| Complete blood count (CBC) | 1.00 | $54.14 | $34.87 | |
| Fine-needle aspiration biopsy | 0.29 | $459.00 | $832.00 | |
| Open biopsy | 0.67 | $8765.00 | $2963.86 | |
| Bilateral mammogram | 1.00 | $213.00 | $1484.00 | |
| Liver function tests (LFTs) | 1.00 | $245.00 | $157.78 | |
| Electrocardiography (ECG) | 1.00 | $356.00 | $229.26 | |
| Monitoring of bones | 1.00 | $367.00 | $236.35 | |
| Subtotal | $10,459.10 | $5938.12 | ||
| Stage-I treatment | Surgical interventions | 0.98 | $16,791.61 | $10,813.80 |
| • Lymph node dissection | 0.04 | $13,713.26 | $8831.34 | |
| • Lumpectomy + lymph node dissection | 0.15 | $13,538.89 | $8719.05 | |
| • Lumpectomy + lymph node dissection + sentinel lymph node biopsy | 0.74 | $16,415.65 | $10,571.68 | |
| • Mastectomy + sentinel lymph node biopsy | 0.02 | $23,603.19 | $15,200.46 | |
| • Mastectomy + lymph node dissection | 1.0 | $13,736.19 | $8846.11 | |
| • Reconstructive surgery | 0.01 | $29,559.32 | $19,036.20 | |
| • Mastectomy + reconstructive surgery | 0.02 | $30,952.28 | $19,933.27 | |
| • Mastectomy + sentinel lymph node biopsy + lymph node dissection + reconstructive surgery | 0.02 | $41,456.47 | $26,697.97 | |
| Radiotherapy | 0.54 | $11,759.82 | $8,231.87 | |
| Chemotherapy | 0.69 | $75,224.26 | $49,648.01 | |
| FEC (6–8 cycles) | 0.20 | $171,913.65 | $113,463.01 | |
| FEC (4 cycles) | 0.18 | $99,217.57 | $65,483.60 | |
| CMF (6 cycles) | 0.19 | $6541.20 | $4317.19 | |
| Epirubicin + Taxotere (4 cycles) | 0.02 | $124,198.00 | $81,970.68 | |
| Trastuzumab (Weekly for 8 months)/2 | 0.08 | $248,257.21 | $163,849.76 | |
| Stage-II treatment | Surgical interventions | 0.96 | $18,003.15 | $11,594.03 |
| • Lymph node dissection | 0.04 | $13,713.26 | $8831.34 | |
| • Lumpectomy + lymph node dissection | 0.24 | $13,538.89 | $8,719.05 | |
| • Lumpectomy + lymph node dissection + sentinel lymph node biopsy | 0.48 | $16,415.65 | $10,571.68 | |
| • Mastectomy + sentinel lymph node biopsy | 0.03 | $23,603.19 | $15,200.46 | |
| • Mastectomy + lymph node dissection | 0.03 | $13,736.19 | $8846.11 | |
| • Mastectomy + sentinel lymph node biopsy + lymph node dissection | 0.10 | $24,115.00 | $15,530.06 | |
| • Reconstructive surgery | 0.02 | $29,559.32 | $19,036.20 | |
| • Mastectomy + reconstructive surgery | 0.02 | $30,952.28 | $19,933.27 | |
| • Mastectomy + sentinel lymph node biopsy + lymph node dissection + reconstructive surgery | 0.04 | $41,456.47 | $26,697.97 | |
| Radiotherapy | 0.38 | $11,759.82 | $5792.18 | |
| Chemotherapy | 1.18 | $132,983.07 | $87,768.83 | |
| FEC (6–8 cycles) | 0.35 | $171,913.65 | $113,463.01 | |
| FEC (4 cycles) | 0.21 | $99,217.57 | $65,483.60 | |
| CMF (6 cycles) | 0.27 | $6541.20 | $4317.19 | |
| GemCarbo (6 cycles) | 0.02 | $57,509.40 | $37,956.20 | |
| Capecitabine (6 cycles) | 0.01 | $67,192.80 | $44,347.25 | |
| Navelbine (6 cycles) | 0.01 | $38,347.80 | $25,309.55 | |
| Epirubicin + Taxotere (4 cycles) | 0.12 | $124,198.00 | $81,970.68 | |
| Trastuzumab (Weekly for 8 months)/2 | 0.13 | $248,257.21 | $163,849.76 | |
| Stage-III treatment | Surgical interventions | 0.96 | $22,203.78 | $14,299.23 |
| • Lumpectomy + lymph node dissection | 0.01 | $13,538.89 | $8,719.05 | |
| • Lumpectomy + lymph node dissection + sentinel lymph node biopsy | 0.02 | $16,415.65 | $10,571.68 | |
| • Mastectomy + sentinel lymph node biopsy | 0.09 | $23,603.19 | $15,200.46 | |
| • Mastectomy + lymph node dissection | 0.26 | $13,736.19 | $8846.11 | |
| • Mastectomy + sentinel lymph node biopsy + lymph node dissection | 0.41 | $24,115.00 | $15,530.06 | |
| • Reconstructive surgery | 0.04 | $29,559.32 | $19,036.20 | |
| • Mastectomy + reconstructive surgery | 0.06 | $30,952.28 | $19,933.27 | |
| • Mastectomy + sentinel lymph node biopsy + lymph node dissection + reconstructive surgery | 0.08 | $41,456.47 | $26,697.97 | |
| Radiotherapy | 0.12 | $11,759.82 | $8,231.87 | |
| Chemotherapy | 1.43 | $177,968.02 | $117,458.90 | |
| FEC (6–8 cycles) | 0.25 | $171,913.65 | $113,463.01 | |
| FEC (4 cycles) | 0.14 | $99,217.57 | $65,483.60 | |
| CMF (6 cycles) | 0.18 | $6541.20 | $4317.19 | |
| GemCarbo (6 cycles) | 0.09 | $57,509.40 | $37,956.20 | |
| Capecitabine (6 cycles) | 0.05 | $67,192.80 | $44,347.25 | |
| Navelbine (6 cycles) | 0.06 | $38,347.80 | $25,309.55 | |
| Epirubicin + Taxotere (4 cycles) | 0.44 | $124,198.00 | $81,970.68 | |
| Trastuzumab (Weekly for 8 months)/2 | 0.16 | $248,257.21 | $163,849.76 | |
| Stage-IV treatment | Surgical interventions | 1.00 | $24,594.50 | $15,838.86 |
| • Lymph node dissection | 0.04 | $13,713.26 | $8831.34 | |
| • Mastectomy + sentinel lymph node biopsy | 0.15 | $23,603.19 | $15,200.46 | |
| • Mastectomy + lymph node dissection | 0.21 | $13,736.19 | $8846.11 | |
| • Mastectomy + sentinel lymph node biopsy + lymph node dissection | 0.32 | $24,115.00 | $15,530.06 | |
| • Reconstructive surgery | 0.05 | $29,559.32 | $19,036.20 | |
| • Mastectomy + reconstructive surgery | 0.09 | $30,952.28 | $19,933.27 | |
| • Mastectomy + sentinel lymph node biopsy + lymph node dissection + reconstructive surgery | 0.14 | $41,456.47 | $26,697.97 | |
| Radiotherapy | 0.04 | $11,759.82 | $8,231.87 | |
| Chemotherapy | 0.48 | $52,296.54 | $34,515.71 | |
| FEC (6–8 cycles) | 0.01 | $171,913.65 | $113,463.01 | |
| FEC (4 cycles) | 0.02 | $99,217.57 | $65,483.60 | |
| CMF (6 cycles) | 0.04 | $6541.20 | $4317.19 | |
| GemCarbo (6 cycles) | 0.05 | $57,509.40 | $37,956.20 | |
| Capecitabine (6 cycles) | 0.13 | $67,192.80 | $44,347.25 | |
| Navelbine (6 cycles) | 0.14 | $38,347.80 | $25,309.55 | |
| Epirubicin + Taxotere (4 cycles) | 0.03 | $124,198.00 | $81,970.68 | |
| Trastuzumab (Weekly for 8 months)/2 | 0.05 | $248,257.21 | $163,849.76 | |
| Bevacizumab | 0.04 | $380,581.01 | $251,183.47 | |
*
The ‘Use of service’ column refers to the number of times a procedure is performed by a user in one-year follow-up.
Sources: Data of the IMSS and FPGC Operative Medical Information System (SIMO). Tabulator for recovery quotas of the INCAN. Unit costs for medical care by level of care. Undersecretary of Income. Unit for Income Policy. Mexican Secretariat of Finance and Public Credit. 2009. IMSS 2009 published in DOF (6-03-2009 second section 65–68).